FRAT-up, a Web-based fall-risk assessment tool for elderly people living in the community.

Background: About 30% of people over 65 are subject to at least one unintentional fall a year. Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive research, existing assessment tools for fall risk have been insufficient for predicting falls. Objective: The goal of this study is to present a novel web-based fall-risk assessment tool (FRAT-up) and to evaluate its accuracy in predicting falls, within a context of community-dwelling persons aged 65 and up. Methods: FRAT-up is based on the assumption that a subject\u2019s fall risk is given by the contribution of their exposure to each of the known fall-risk factors. Many scientific studies have investigated the relationship between falls and risk factors. The majority of these studies adopted statistical approaches, usually providing quantitative information such as odds ratios. FRAT-up exploits these numerical results to compute how each single factor contributes to the overall fall risk. FRAT-up is based on a formal ontology that enlists a number of known risk factors, together with quantitative findings in terms of odds ratios. From such information, an automatic algorithm generates a rule-based probabilistic logic program, that is, a set of rules for each risk factor. The rule-based program takes the health profile of the subject (in terms of exposure to the risk factors) and computes the fall risk. A Web-based interface allows users to input health profiles and to visualize the risk assessment for the given subject. FRAT-up has been evaluated on the InCHIANTI Study dataset, a representative population-based study of older persons living in the Chianti area (Tuscany, Italy). We compared reported falls with predicted ones and computed performance indicators. Results: The obtained area under curve of the receiver operating characteristic was 0.642 (95% CI 0.614-0.669), while the Brier score was 0.174. The Hosmer-Lemeshow test indicated statistical significance of miscalibration. Conclusions: FRAT-up is a web-based tool for evaluating the fall risk of people aged 65 or up living in the community. Validation results of fall risks computed by FRAT-up show that its performance is comparable to externally validated state-of-the-art tools. A prototype is freely available through a web-based interface. Trial Registration: ClinicalTrials.gov NCT01331512 (The InChianti Follow-Up Study); http://clinicaltrials.gov/show/NCT01331512 (Archived by WebCite at http://www.webcitation.org/6UDrrRuaR)

Physical activity trajectories, mortality, hospitalization, and disability in the Toledo Study of Healthy Aging

Background: Physical activity (PA) is a recognized contributor to healthy aging. However, the majority of studies exploring its associations with adverse outcomes in cohorts of older adults use single-time PA estimates, which do not consider its dynamic nature. The aim of the present study is to explore the presence of different PA trajectories in the Toledo Study of Healthy Aging and their association with adverse outcomes. Our hypothesis is that prospectively maintaining or increasing PA is associated with a reduced risk of adverse outcomes. Methods: We used data from 1679 participants enrolled in the Toledo Study of Healthy Aging. Trajectories based on the Physical Activity Scale for the Elderly were identified using group-based trajectory modelling. Cox and logistic regression were used to investigate associations between PA trajectories and mortality and hospitalization, and incident and worsening disability, respectively. Mortality was ascertained by linkage to the Spanish National Death Index; disability was evaluated through the Katz Index; and hospitalization was defined as the first admission to Toledo Hospital. Models were adjusted by age, sex, smoking, Charlson Index, education, cognitive impairment, polypharmacy, and Katz Index at Wave 2. Results: We found four PA-decreasing and one PA-increasing trajectories: high PA-consistent (n = 566), moderate PA-mildly decreasing (n = 392), low PA-increasing (n = 237), moderate PA-consistent (n = 191), and low PA-decreasing (n = 293). Belonging to the high PA-consistent trajectory group was associated with reduced risks of mortality as compared with the low PA-decreasing group [hazard ratio (HR) 1.68; 95% confidence interval (CI) = 1.21–2.31] and hospitalization compared with the low PA-increasing and low PA-decreasing trajectory groups (HR 1.24; 95% CI = 1.004–1.54 and HR 1.25; 95% CI = 1.01–1.55, respectively) and with lower rates of incident [odds ratio (OR) 3.14; 95% CI = 1.59–6.19] and worsening disability (OR 2.16; 95% CI = 1.35–3.45) in relation to the low PA-decreasing trajectory group and at follow-up. Increasing PA during late life (low PA-increasing group) was associated with lower incident disability rates (OR 0.38; 95% CI = 0.19–0.82) compared with decreasing PA (low PA-decreasing group), despite similar baseline PA. Conclusions: Our results suggest that sustaining higher PA levels during aging might lead to healthy aging, characterized by a reduction in adverse outcomes. Our study supports the need for enhancing PA participation among older populations, with the goal of reducing personal and economic burden in a worldwide aging population.The present work was funded by grants from the Spanish Ministry of Economy, Industry and Competitiveness, cofinanced by the European Regional Development Funds (RD120001/0043) and the Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CB16/10/00464)

A Survey of Sport Fishing in the Illinois Portion of Lake Michigan March through September 1997

F-52-R12Report issued on: May 1998INHS Technical Report prepared for Illinois Department of Natural Resource

Reliability, validity and educational use of the Cognitive Abilities Profile

The Cognitive Abilities Profile (CAP) (Deutsch and Mohammed, 2010) is a collaborative tool for psychologists and teachers. The CAP is based on principles of Dynamic Assessment (DA) and uses a consultative model for rating pupils’ cognitive abilities in various cognitive domains and for planning interventions to facilitate pupils’ progress accordingly. The CAP was developed in response to a perceived need for educational psychologists (EPs) to have access to alternative assessments to standardised psychological tests, particularly in the case of learning disadvantaged and ethnic minority pupils. Using DA as one possible approach creates a need for EPs to have access to training and to receive support with the implementation of DA-based intervention methods within local services. However, surveys of EP use of DA indicate limitations in training, inadequate support and difficulties in wider application of DA. In the present work, a quantitative methodology has been used to examine the validity and reliability of the CAP in overcoming the above-noted difficulties in the implementation of DA by EPs. The methodology involved the collection and analysis of data from three groups of EPs, two of which conducted consultations with teachers using the CAP and the third group of EPs used its own choice of consultation methodology and functioned as a control group. The findings of the present work provide evidence of good construct validity of the CAP cognitive domains, adequate inter-rater reliability between CAP users and evidence of advantage for pupils in some areas of functioning between pre- and post-use of the CAP, as validated by independent standardised tests. Analysis of perceptions of EPs of the utility of the CAP, based on the results of feedback questionnaires, addresses issues of user friendliness of the CAP. CAP users agreed on the need for initial training for psychologists and support for practitioners. The findings have implications for adoption of a novel approach in EP and teacher related work

A Review of South African research in the field of dynamic assessment

Dynamic assessment, which is often characterised by the learning potential approach across the world and in South Africa, is receiving more and more attention from educators and research practitioners alike. The nature of dynamic assessment lends itself to application in areas where prior dependence on static (traditional) forms of psychometric assessment can no longer be sustained as viable options towards assessment. A main focus area within dynamic assessment is the field of tertiary selections and admissions. More research is needed in this field in South Africa and in order to progress within the field in this country in terms of designing, developing, norming and implementing dynamic assessment tests/batteries, previous research has to be investigated in detail in order to understand the areas which need attention and improvement more fully. In addition, it is not only the negative aspects which need to be investigated but also the success with which many studies have been greeted which needs to be looked at. Investigating the status of South African research into the field of dynamic assessment offers the interested practitioner a platform from which to view results that have emanated from this country in the past fifteen years. Past reliance on static measures meant that product-based assessment made no allowance for the detection and measurement of potential within individuals. It is not the contention of this study to state unequivocally that all disadvantaged students possess equal potential, but that a large pool of learners with potential are often passed over during selection for admission. In order to address these and similar issues, new tests will have to be developed but these can only be developed once past and current research is properly assessed. This is the aim of the present study. There is no document yet available on the status of dynamic assessment in South Africa which pays close attention to the research details of various findings within this field. The main findings indicate that although the field is still being researched today, there has been a decrease in the number of studies as well as a concomitant decrease in the implementation of dynamic research efforts. The reasons cited are lack of time, costs, inefficiencies and also confusion as to what dynamic assessment entails. There is, as yet, no consistent definition of dynamic assessment in South Africa, which makes it all the harder to entrench dynamic assessment as a methodology and implement it on as wide a scale as possible. Most research efforts in this field in South Africa presently comprise Master's and Doctoral studies and are, for the most part, efforts emanating from a handful of tertiary institutions. Some past research efforts have been successful but have since been disbanded, whereas there has been a growing awareness of the usefulness of dynamic assessment but it is not being implemented for the reasons stated above. This study investigates these results. Dynamic assessment is most certainly a prudent and effective partial solution to the issue of assessment in South Africa and can no longer be ignored. Yet, with cautious interpretation of the results, researchers and practitioners in the field will be better able to arrive at a more informed opinion of the advances in the field when allowed to scour past and present research.Thesis (MA (Research Psychology))--University of Pretoria, 2003.Psychologyunrestricte

Transatlantic Taskforce on Antimicrobial Resistance : progress report

The Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) was created in 2009 with the goal of improving cooperation between the US and the EU in three key areas: appropriate therapeutic use of antimicrobial drugs in medical and veterinary communities, prevention of healthcare- and community-associated drug-resistant infections, and strategies for improving the pipeline of new antimicrobial drugs. TATFAR identified and adopted 17 recommendations for future collaborations between the US and the EU. The implementation of the recommendations has been carried out through increased communication; regular meetings and joint workshops; and exchange of information and approaches, best practises and methods.This report summarises the progress and the outcomes of the implementation of the 17 recommendations, as well as the decision about the future of each recommendation. In addition, it also includes one new recommendation.Based on the promise shown by our early cooperation, we decided to renew TATFAR in 2013 for another two-year term. In addition, we agreed to transfer the Secretariat from the European Centre for Disease Prevention and Control (ECDC) to the US Centers for Disease Control and Prevention (CDC) for the renewal term. As TATFAR moved into its two-year renewal period, this report reviews the progress that has been made for each recommendation and feedback to determine whether work toward the recommendation should continue in the future. Work on 15 of the original TATFAR recommendations and one new recommendation will continue into 2015, a strong testament to the benefits of the cooperation between the US and EU.tatfar-progress_report_2014.pdfForeword -- Executive summary -- Introduction -- Recommendations -- Key Area I. Appropriate therapeutic use of antimicrobial drugs in medicine -- Key Area II. Prevention of drug resistant infections -- Key Area III. Strategies to improve the pipeline of new antibacterial drugs for use in human medicine -- Conclusions -- Acknowledgement -- Annex A: Abbreviations and acronyms -- Annex B: TATFAR members -- Annex C: Scope and term of reference of TATFAR -- Annex D: The TATFAR recommendations for future collaboration -- Annex E: Timeline of the TATFAR, 2009-2013 -- Annex F: Ongoing activities: joint, EU, and US